Effect of double-layer application on the early enamel bond strength of universal adhesives.

OBJECTIVES: The present study aimed to investigate the changes in the enamel bond strengths of universal adhesives in the early phase of specimen creation and evaluate the effect of double-layer application on enamel bond effectiveness using different etching modes.
METHOD: Four universal adhesives, namely Clearfil Universal Bond Quick, G-Premio Bond, Scotchbond Universal, and Tokuyama Universal Bond, were used. Clearfil SE Bond two-step self-etch adhesive system was used as a comparison. Fifteen specimens per group were used for determining the shear bond strength (SBS) to bovine enamel in the etch-and-rinse or self-etch mode. The adhesive was applied to specimens in accordance with the manufacturers' instructions (single-layer application), or the adhesive was applied twice (double-layer application). The bonded specimens were stored in distilled water at 37 °C for 5 min or 1, 6, 12, or 24 h before SBS testing. The flexural properties of the resin composite Clearfil AP-X were measured for the same storage periods.
RESULTS: All universal adhesives exhibited increased SBS values with prolonged storage periods regardless of the application technique or etching mode used. Double-layer application was associated with higher SBS values than single-layer application for most universal adhesives over the same storage period.
CONCLUSION: Phosphoric acid pre-etching and double-layer application of universal adhesives resulted in increased enamel bond strength in the early phase of specimen bonding. CLINICAL RELEVANCE: Care should be taken when using universal adhesives in the self-etch mode for enamel bonding because the enamel adhesion is sensitive to the duration after filling.